First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after November 6, claims missing the required infor…
There could be several reasons why your claim was denied or otherwise did not process successfully. Use these available resources to identify claims processing codes.
First Coast has been made aware of complaints by beneficiaries being required to pay for services up front. This article explains what may occur when indicating a patient payment amount on a claim and provides solutions when assignment is a…
First Coast has noticed an increase in errors on the CMS-1500 (02/12) claim form. This article addresses important instructions regarding completion of the paper claim form.
Did you know the leading reason why the Recovery Audit Contractor denies the drug Octagam during a medical review is for lack of documentation? Learn more about preventing unnecessary denials.
Payment for ambulatory surgical centers (ASCs) are made under a separate payment system. As such, certain modifiers are specific to ASCs. This article explores these modifiers.
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or later.